Diagnostic performance of ultrasound for myositis and fasciitis, including necrotizing fasciitis, in pediatric patients.

Abstract

Objectives: To demonstrate the diagnostic performance of ultrasound for abnormal magnetic resonance imaging findings in pediatric patients with suspected myositis and fasciitis. We compared sonographic findings between patients with and without necrotizing fasciitis.

Methods: In 21 pediatric patients, the presence or absence of abnormal T2-high signal intensity in subcutaneous fat, peripheral deep fascia, intermuscular fascia, and muscle was recorded. The extent of the disease based on ultrasound findings was recorded according to the previous locations. The vascular lumen within the affected muscle was also evaluated. Patients were classified into two groups: those with necrotizing fasciitis and those without. The presence/absence of sonographic findings and width of fluid accumulation in the peripheral deep fascia was compared between the two groups.

Results: Three patients were classified into the necrotizing fasciitis group. The ultrasound diagnostic performance for abnormal findings in subcutaneous fat/peripheral deep fascia/ intermuscular fascia/muscle was 90.5%/76.2%/47.6%/90.5%, respectively. The presence/absence of abnormal findings in peripheral deep fascial edema, its width and vascular lumen collapse were significantly different between the two groups. The other findings were not significantly different between the groups.

Conclusions: Ultrasound demonstrated reliability in detecting abnormal findings and was useful for diagnosing necrotizing fasciitis, facilitating urgent surgical intervention.